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An J, Freeman E, Stewart IJ, Dore M. Association of Traumatic Brain Injury and Glioblastoma Multiforme: A Case Series. Mil Med 2024; 189:e391-e395. [PMID: 37223958 DOI: 10.1093/milmed/usad162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/10/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023] Open
Abstract
Glioblastoma multiforme (GBM) is an aggressive variant of central nervous system gliomas that carries a dismal prognosis. Although GBM is the most frequently occurring and malignant type of glioma accounting for more than 60% of all brain tumors in adults, its overall incidence is rare, occurring at a rate of 3.21 per 100,000 persons. Little is known about the etiology of GBM, but one proposed theory is that GBM pathogenesis may be linked to a chronic inflammatory course initiated by traumatic injury to the brain. Limited case reports have suggested an association between GBMs and traumatic brain injury (TBI), but larger case-control and epidemiologic studies have been inconclusive. We present three service members (two active duty and one retired) who developed GBM near the original site of prior head trauma. Each service member's military occupation was in the special operations community and shared a common theme of TBI following head trauma/injury. The current research on the association between TBI and GBM is limited and conflicting, predominantly due to the low incidence of the disease in the general population. Evidence has indicated that TBI should be considered a chronic disease with long-term health impacts, including long-term disability, dementia, epilepsy, mental health conditions, and cardiovascular diseases. With the addition of our patients, as well as a recently published study proposing a molecular association between trauma and GBM, further research is needed to better understand the potential relationship.
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Affiliation(s)
- Joseph An
- Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
| | - Emily Freeman
- Department of Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
| | - Ian J Stewart
- Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Military Cardiovascular Outcomes Research Center, Uniformed Services University, Bethesda, MD 20814, USA
| | - Michael Dore
- Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
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2
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Chen K, Andrade-Barazarte H, Liang W, Zhu Q, Guo H, Li Y, Li H, Qian R. Post-traumatic brain injury glioma: Characteristics, report of 2 cases report and literature review. Medicine (Baltimore) 2022; 101:e32477. [PMID: 36596004 PMCID: PMC9803520 DOI: 10.1097/md.0000000000032477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) as a pathogenetic factor in glioma remains controversial, and currently there is still no clear mechanism behind post-TBI glioma. Thus, we provide two case reports of post-TBI glioma contributing power to this research, and we provide a summary of the mechanisms of post-TBI glioma through literature review. METHODS We report two cases of brain gliomas that developed in the scar of a previous brain trauma. Both patients were male and both had suffered prior traumatic brain injuries (time interval 10-20 years), and postoperative pathological findings reported glioblastoma and WHO grade III glioma, respectively. RESULTS These two cases further support the association of between traumatic brain injury and gliomas development. CONCLUSION Although the epidemiological investigation between TBI and glioma is still controversial, there are still some important aspects here that can determine the possibility between TBI and gliomagenesis. Besides, we found that the reparative response of neural stem cells and the dysregulation of inflammatory cells are timportant theories of the mechanism of post-TBI glioma.
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Affiliation(s)
- Kui Chen
- People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China
| | - Hugo Andrade-Barazarte
- Department of Neurosurgery, Henan Provincial People’s Hospital, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Wenjia Liang
- People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China
| | - Qingyun Zhu
- People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China
| | - Haixing Guo
- People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China
| | - Yanxin Li
- Department of Neurosurgery, Henan Provincial People’s Hospital, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Haichun Li
- Department of Neurosurgery, Henan Provincial People’s Hospital, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Rongjun Qian
- Department of Neurosurgery, Henan Provincial People’s Hospital, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- * Correspondence: Rongjun Qian, Department of Neurosurgery, Henan Provincial People’s Hospital, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province 450003, China (e-mail: )
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3
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Finneran MM, Young M, Joyce L, Nardone EM. Glioblastoma 20 years after a nail gun trauma: A risk factor? Clin Case Rep 2022; 10:e05927. [PMID: 35662785 PMCID: PMC9163479 DOI: 10.1002/ccr3.5927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/07/2022] [Accepted: 04/25/2022] [Indexed: 11/08/2022] Open
Abstract
A 48-year-old man presented with headaches and confusion. Imaging demonstrated a right frontal glioblastoma multiforme (GBM), twenty years after a nail gun injury to the same region. GBM in the same location as a previous injury points toward possible causation from the trauma in the development of a high-grade glioma.
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Affiliation(s)
| | - Michael Young
- Neurological SurgeryCarle BroMenn Medical CenterNormalIllinoisUSA
| | - Larry Joyce
- Department of PathologyOSF St. Joseph Medical CenterBloomingtonIllinoisUSA
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4
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Shah DS, Sanan A, Morell AA, Eichberg DG, Shah AH, Luther E, Lu VM, Elarjani T, Higgins DMO, Patel NV, Jagid JR, Ivan ME, Komotar RJ. Traumatic brain injury and subsequent brain tumor development: a systematic review of the literature. Neurosurg Rev 2022; 45:3003-3018. [PMID: 35641842 DOI: 10.1007/s10143-022-01819-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/29/2022] [Accepted: 05/19/2022] [Indexed: 12/01/2022]
Abstract
The role of prior head trauma in stimulating brain tumor development has been previously described in the literature but continues to be debated. The goal of this study was to conduct a systematic review interrogating the contemporary literature to delineate any possible relationship between traumatic brain injury and brain tumor development. A systematic review exploring development of post-TBI brain tumor was conducted by searching electronic databases. Abstracts from articles were read and selected for full-text review according to criteria previously established in the scientific literature. Relevant full-text articles were divided into case reports and single-arm studies and epidemiological studies. Of 1070 resultant articles, 18 case reports and single-arm studies (level of evidence of IV and V) with 45 patients were included. The most common cause of TBI was traffic accidents. The average period between TBI and subsequent tumor diagnosis was 12.8 years. Meningiomas represented the largest share of tumors, followed by gliomas. Most post-TBI brain tumors developed in the frontal and temporal lobes. Fifteen epidemiological studies were also interrogated from a variety of countries (level of evidence of III). Case-control studies were more common than cohort studies. There were 9 of 15 studies proposed a possible relationship between history of head trauma and development of brain tumor. The relationship between head trauma and neoplastic growth continues to be heavily debated. There are certainly case reports and epidemiological studies in the literature that suggest a correlational relationship between the two. However, there is no concrete evidence of a causal relationship between TBI and brain tumors. More research is needed to definitively delineate the extent of any such relationship.
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Affiliation(s)
- Darsh S Shah
- Department of Neurological Surgery, Dell Medical School, University of Texas at Austin, 501 Red River St., Austin, TX, 78712, USA.
| | - Akshat Sanan
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Alexis A Morell
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Daniel G Eichberg
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Ashish H Shah
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Evan Luther
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Victor M Lu
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Turki Elarjani
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | | | - Nitesh V Patel
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Jonathan R Jagid
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Michael E Ivan
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
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5
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Abstract
Traumatic brain injury (TBI) was first proposed as a potential risk factor for developing a glioma in the 1800s, and conditions for establishing a causal relationship between brain injury and gliomas have since been proposed. Given the medical and legal ramifications, the current literature was reviewed to better understand this possible association. Articles that examined the relationship between TBI and glioma formation in adults and were published in English between 1978 and 2022 were reviewed. There were 19 case reports of 25 patients and 16 observational studies. The case reports describe glioma formation at the precise site of prior brain injury in continuity with traumatic scar; the observational studies report conflicting findings, but they largely demonstrate no association. Most of the observational studies are limited by their retrospective nature, but we identified one prospective cohort study which found a positive association. Altogether, we suggest that glioma formation after TBI is a rare occurrence that warrants further study.
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6
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Lan YL, Zhu Y, Chen G, Zhang J. The Promoting Effect of Traumatic Brain Injury on the Incidence and Progression of Glioma: A Review of Clinical and Experimental Research. J Inflamm Res 2021; 14:3707-3720. [PMID: 34377008 PMCID: PMC8350857 DOI: 10.2147/jir.s325678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 07/23/2021] [Indexed: 12/16/2022] Open
Abstract
The role of traumatic brain injury in the development of glioma is highly controversial since first presented. This is not unexpected because traumatic brain injuries are overwhelmingly more common than glioma. However, the causes of post-traumatic glioma have been long discussed and still warrant further research. In this review, we have presented an overview of previous cohort studies and case–control studies. We have summarized the roles of microglial cells, macrophages, astrocytes, and stem cells in post-traumatic glioma formation and development, and reviewed various carcinogenic factors involved during traumatic brain injury, especially those reported in experimental studies indicating a relationship with glioma progression. Besides, traumatic brain injury and glioma share several common pathways, including inflammation and oxidative stress; however, the exact mechanism underlying this co-occurrence is yet to be discovered. In this review, we have summarized current epidemiological studies, clinical reports, pathophysiological research, as well as investigations evaluating the probable causes of co-occurrence and treatment possibilities. More efforts should be directed toward elucidating the relationship between traumatic brain injury and glioma, which could likely lead to promising pharmacological interventions towards designing therapeutic strategies.
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Affiliation(s)
- Yu-Long Lan
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.,Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.,Department of Neurosurgery, Shenzhen People's Hospital, Shenzhen, People's Republic of China
| | - Yongjian Zhu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Gao Chen
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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7
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Abstract
We report two cases of brain glioma that developed in the scar of an old brain trauma. The first is that of a 40-year-old man who presented with severe headaches; CT and MRI showed a large mass in the right parietal region. The tumor was unresectable and surgical biopsy showed a glioblastoma multiforme. The patient had suffered a cranial trauma in a road accident 20 years previously with an intrathecal hematoma in the right parietal region. The second case concerns a 60-year-old man who, 15 years after severe head injury in a road accident, developed a glioblastoma multiforme which was localized in the scar of the brain contusion. These cases fulfill the established criteria for a traumatic origin of brain tumors and add further support to the relationship between cranial trauma and the onset of glioma. As stated by other authors, an association between head trauma and brain tumor risk cannot be ruled out and should be studied further.
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Affiliation(s)
- Elisa Anselmi
- Department of Oncology and Hematology, Hospital of Piacenza, Piacenza, Italy
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8
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The Pathophysiology of Post-Traumatic Glioma. Int J Mol Sci 2018; 19:ijms19082445. [PMID: 30126222 PMCID: PMC6121393 DOI: 10.3390/ijms19082445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 12/27/2022] Open
Abstract
Malignant glioma is a brain tumor with a very high mortality rate resulting from the specific morphology of its infiltrative growth and poor early detection rates. The causes of one of its very specific types, i.e., post-traumatic glioma, have been discussed for many years, with some studies providing evidence for mechanisms where the reaction to an injury may in some cases lead to the onset of carcinogenesis in the brain. In this review of the available literature, we discuss the consequences of breaking the blood–brain barrier and consequences of the influx of immune-system cells to the site of injury. We also analyze the influence of inflammatory mediators on the expression of genes controlling the process of apoptosis and the effect of chemical mutagenic factors on glial cells in the brain. We present the results of experimental studies indicating a relationship between injury and glioma development. However, epidemiological studies on post-traumatic glioma, of which only a few confirm the conclusions of experimental research, indicate that any potential relationship between injury and glioma, if any, is indirect.
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9
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Salvati M, Caroli E, Rocchi G, Frati A, Brogna C, Orlando ER. Post-Traumatic Glioma. Report of Four Cases and Review of the Literature. TUMORI JOURNAL 2018; 90:416-9. [PMID: 15510986 DOI: 10.1177/030089160409000410] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background To add a further contribution to the literature supporting the relationship between previous head trauma and development of glioma. Methods We report on four patients who developed brain gliomas in the scar of an old brain injury. Results All cases fulfilled the widely established criteria for brain tumors of traumatic origin. In all of our cases there was radiological evidence of absence of tumor at the time of the injury. Conclusions We believe that in specific cases it is reasonable to acknowledge an etiological association between a severe head trauma and the development of a glioma. This assumption is further sustained if there is radiological and surgical documentation of the absence of neoplasia at the moment of the trauma.
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Affiliation(s)
- Maurizio Salvati
- Department of Neurosurgery, INM Neuromed IRCCS, Pozzilli, Italy.
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10
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Tyagi V, Theobald J, Barger J, Bustoros M, Bayin NS, Modrek AS, Kader M, Anderer EG, Donahue B, Fatterpekar G, Placantonakis DG. Traumatic brain injury and subsequent glioblastoma development: Review of the literature and case reports. Surg Neurol Int 2016; 7:78. [PMID: 27625888 PMCID: PMC5009580 DOI: 10.4103/2152-7806.189296] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/28/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous reports have proposed an association between traumatic brain injury (TBI) and subsequent glioblastoma (GBM) formation. METHODS We used literature searches and radiographic evidence from two patients to assess the possibility of a link between TBI and GBM. RESULTS Epidemiological studies are equivocal on a possible link between brain trauma and increased risk of malignant glioma formation. We present two case reports of patients with GBM arising at the site of prior brain injury. CONCLUSION The hypothesis that TBI may predispose to gliomagenesis is disputed by several large-scale epidemiological studies, but supported by some. Radiographic evidence from two cases presented here suggest that GBM formed at the site of brain injury. We propose a putative pathogenesis model that connects post-traumatic inflammation, stem and progenitor cell transformation, and gliomagenesis.
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Affiliation(s)
- Vineet Tyagi
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Jason Theobald
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA
| | - James Barger
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA
| | - Mark Bustoros
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA
| | - N Sumru Bayin
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA; Kimmel Center for Stem Cell Biology, NYU School of Medicine, Brooklyn, New York, USA
| | - Aram S Modrek
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA
| | - Michael Kader
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA
| | - Erich G Anderer
- Division of Neurosurgery, Maimonides Medical Center, Brooklyn, New York, USA
| | - Bernadine Donahue
- Department of Radiation Oncology, NYU School of Medicine, Brooklyn, New York, USA; Maimonides Cancer Center, Brooklyn, New York, USA
| | - Girish Fatterpekar
- Department of Radiology, NYU School of Medicine, Brooklyn, New York, USA
| | - Dimitris G Placantonakis
- Department of Neurosurgery, NYU School of Medicine, Brooklyn, New York, USA; Kimmel Center for Stem Cell Biology, NYU School of Medicine, Brooklyn, New York, USA; Brain Tumor Center, NYU School of Medicine, Brooklyn, New York, USA
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11
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Chaurasia I, Chaudhary A, Verma N, Chaurasia IK, Koshariya M, Songra M. Post Traumatic Glioma – An association questioned. ROMANIAN NEUROSURGERY 2015. [DOI: 10.1515/romneu-2015-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractPost traumatic glioma has been a matter of debate. Few reports favor its occurrence in previous head injury scar, subsequently developing into glioma. Here we report a case of young patient presented with headache, seizures and gradual loss of vision. On investigation found to have brain tumor. Patient had head injury occurred 3 yrs back. It fulfills all the criteria required to establish traumatic origin, further supporting the association.
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12
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An intraventricular meningioma and recurrent astrocytoma collision tumor: a case report and literature review. World J Surg Oncol 2015; 13:37. [PMID: 25889820 PMCID: PMC4329203 DOI: 10.1186/s12957-015-0436-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 01/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intracranial meningioma and glioma collision tumors are relatively uncommon and are even more rarely located within the ventricles. CASE PRESENTATION Here, we report a case of a patient with an intraventricular meningioma and astrocytoma collision tumor. A 39-year-old man previously underwent excision of an astrocytoma in the triangle area of the lateral ventricle and exhibited good post-surgery recovery. The astrocytoma recurred in situ six years after the surgery, and the case was complicated by a malignant meningioma. The patient recovered well after surgery to treat the recurrence and was administered radiotherapy after discharge. In addition to reporting on this case, we conducted a literature review of collision tumors; based on this review, we propose several hypotheses regarding the formation of collision tumors. CONCLUSIONS We conclude that a possible cause of the collision tumor formation between the intracranial meningioma and the astrocytoma was the recurrence of an astrocytoma-induced malignancy of the arachnoid cells in the choroid plexus.
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13
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Abstract
Several radiation-related professional societies have concluded that carcinogenic risks associated with doses below 50-100 mSv are either too small to be detected, or are nonexistent. This is especially important in the context of doses from medical imaging. Radiation exposure to the public from medical imaging procedures is rising around the world, primarily due to increased utilization of computed tomography. Professional societies and advisory bodies consistently recommend against multiplying small doses by large populations to predict excess radiation-induced cancers, in large part because of the potential for sensational claims of health impacts which do not adequately take the associated uncertainties into account. Nonetheless, numerous articles have predicted thousands of future cancers as a result of CT scanning, and this has generated considerable concern among patients and parents. In addition, some authors claim that we now have direct epidemiological evidence of carcinogenic risks from medical imaging. This paper critically examines such claims, and concludes that the evidence cited does not provide direct evidence of low-dose carcinogenicity. These claims themselves have adverse public health impacts by frightening the public away from medically justified exams. It is time for the medical and scientific communities to be more assertive in responding to sensational claims of health risks.
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Affiliation(s)
- Brant A. Ulsh
- Principal Health Physicist, M.H. Chew & Associates, Livermore, CA
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14
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Munch TN, Gørtz S, Wohlfahrt J, Melbye M. The long-term risk of malignant astrocytic tumors after structural brain injury--a nationwide cohort study. Neuro Oncol 2014; 17:718-24. [PMID: 25416827 DOI: 10.1093/neuonc/nou312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 10/16/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Neoplastic transformation of damaged astrocytes has been proposed as a possible pathological mechanism behind malignant astrocytic tumors. This study investigated the association between structural brain injuries causing reactive astrogliosis and long-term risk for malignant astrocytic tumors. METHODS The cohort consisted of all individuals living in Denmark between 1978 and 2011. The personal identification number assigned to all individuals allowed retrieval of diagnoses of traumatic brain injury, cerebral ischemic infarction, and intracerebral hemorrhage from the National Patient Discharge Register. Diagnoses of anaplastic astrocytoma and glioblastoma multiforme (World Health Organization grades III and IV) were retrieved from the Danish Cancer Registry. Rate ratios (RR's) were estimated using log-linear Poisson regression. RESULTS In a cohort of 8.2 million individuals, 404 812 experienced a structural brain injury and 6152 developed a malignant astrocytic tumor. No significant association was observed 1-4 years after a structural brain injury (RR = 1.14; 95% CI: 0.87-1.46), whereas the long-term (5+ y) risk for malignant astrocytic tumors was significantly reduced (RR = 0.68; 95% CI: 0.49-0.90) compared with no injury. The specific long-term risks by type of injury were: traumatic brain injury RR = 0.32 (95% CI: 0.10-0.75); cerebral ischemic infarction RR = 0.69 (95% CI: 0.47-0.96); and intracerebral hemorrhage RR = 1.39 (95% CI: 0.64-2.60). CONCLUSION We found no evidence for an association between structural brain injury and malignant astrocytic tumors within the first 5 years of follow-up. However, our study indicated a protective effect of astrogliosis-causing injuries 5 or more years after structural brain injury.
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Affiliation(s)
- Tina Noergaard Munch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (T.N.M., S.G., J.W., M.M.); Department of Neurosurgery, Copenhagen University Hospital, Denmark (T.N.M.)
| | - Sanne Gørtz
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (T.N.M., S.G., J.W., M.M.); Department of Neurosurgery, Copenhagen University Hospital, Denmark (T.N.M.)
| | - Jan Wohlfahrt
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (T.N.M., S.G., J.W., M.M.); Department of Neurosurgery, Copenhagen University Hospital, Denmark (T.N.M.)
| | - Mads Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (T.N.M., S.G., J.W., M.M.); Department of Neurosurgery, Copenhagen University Hospital, Denmark (T.N.M.)
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15
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Coskun S, Coskun A, Gursan N, Aydin MD. Post-traumatic glioblastoma multiforme: a case report. Eurasian J Med 2011; 43:50-3. [PMID: 25610160 PMCID: PMC4261359 DOI: 10.5152/eajm.2011.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 11/02/2010] [Indexed: 11/22/2022] Open
Abstract
Malignant glioma development after trauma is a rare occurrence. We report a glioblastoma multiforme case that developed after a depressed skull fracture. A 65-year-old man was admitted because of right sided hemiplegia, epilepsy and changes in consciousness due to a malignant glial tumor. He had been operated on for a left calvarial depression fracture caused by cerebral laceration thirty-five years before. Radiologic imaging revealed a large contrast-enhanced mass lesion at the left frontotemporoparietal junction under the depression site. The patient underwent urgent surgery, and radical excision of the mass was achieved. The histopathologic diagnosis was a high-grade glial tumor. Although the possibility of a pre-existing tumor rather than a trauma-induced tumor is very high, the presented case suggests that traumatic cerebral lesions may also be a predisposing factor for the development of malignant glial tumors.
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Affiliation(s)
- Suleyman Coskun
- Department of Neurosurgery, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - Aysenur Coskun
- Department of Anesthesiology, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - Nesrin Gursan
- Department of Pathology, Medical Faculty, Atatürk University, Erzurum, Turkey
| | - Mehmet Dumlu Aydin
- Department of Neurosurgery, Medical Faculty, Atatürk University, Erzurum, Turkey
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16
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Zhou B, Liu W. Post-traumatic glioma: report of one case and review of the literature. Int J Med Sci 2010; 7:248-50. [PMID: 20714434 PMCID: PMC2920569 DOI: 10.7150/ijms.7.248] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Accepted: 07/23/2010] [Indexed: 11/30/2022] Open
Abstract
We report one case of brain glioma that developed in the scar of an old brain trauma. A 45-year-old man who presented with seizures; MRI showed a large mass in the right temporal region. Surgical biopsy showed a glioblastoma multiforme. The patient had suffered a cranial trauma in a road accident 10 years previously with an intracerebral hematoma in the right temporal region. This case fulfills the established criteria for a traumatic origin of brain tumors and adds further support to the relationship between cranial trauma and the onset of glioma. As stated by other authors, an association between head trauma and brain tumor risk cannot be ruled out and should be studied further.
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Affiliation(s)
- Bo Zhou
- Department of Neurosurgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, # 88 Jiefang Road, Hangzhou City, 310009, PR China
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Moorthy RK, Rajshekhar V. Development of glioblastoma multiforme following traumatic cerebral contusion: case report and review of literature. ACTA ACUST UNITED AC 2004; 61:180-4; discussion 184. [PMID: 14751638 DOI: 10.1016/s0090-3019(03)00423-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diagnostic criteria for posttraumatic brain tumors were formulated in the pre-CT (computerized tomography) era. We propose that radiologic criteria incorporating imaging data be added to the existing criteria. CASE DESCRIPTION We report a case of a 56-year-old man who presented with history of raised intracranial pressure of 20 days' duration. Imaging showed a large left frontal intra-axial mass lesion. He had history of head injury 5 years prior with CT evidence of bilateral basifrontal contusions. There was no contrast enhancement at the site of the contusions in an intervening CT scan done 18 months after the trauma. He underwent radical excision of the mass, and the histopathology was reported as glioblastoma multiforme. We formulated additional radiologic criteria for tumors that may present following trauma. A review of the literature of posttraumatic gliomas is also presented. CONCLUSION Fulfillment of the additional radiologic criteria proposed by us will help distinguish a tumor that developed following trauma from that which was present before the occurrence of the injury.
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Affiliation(s)
- Ranjith K Moorthy
- Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India
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Abstract
The authors report a case of an anaplastic astrocytoma which on magnetic resonance imaging and direct visualisation was continuous with an area of gliosis in the left frontal lobe. This gliosis was secondary to a head injury received 19 years earlier that required evacuation of an intracerebral haematoma. This case largely meets the accepted criteria for brain tumour associated with head trauma.
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Affiliation(s)
- R D Henderson
- Departments of Neurology and Neurosurgery, Royal Brisbane Hospital, Herston, 4029, Australia
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